By B. A. Morelli, Reporter

CEDAR RAPIDS, Iowa - Mercy Medical Center in Cedar Rapids laid off a small number of employees in early November amid declining insurance reimbursements and patient volume due to health care reform, according to a hospital spokeswoman.

Twelve positions were eliminated in early November, Mercy spokeswoman Karen Vander Sanden said in an emailed statement. An unspecified number of those employees laid off moved to open positions within the hospital, and all are being "fully supported," she said.

The duties of the eliminate positions have been reassigned while maintaining a high level of quality care and service, she said. "Healthcare reform is driving fundamental changes in how care is delivered across the nation," she said in the statement. "These changes are resulting in declining reimbursements and volumes locally as well as nationally."

Hospitals from California to North Carolina have been eliminating positions citing similar reasons, according to a number news reports in recent weeks, and USA Today reported that the 41,085 health care layoffs through early October were third most of any industry this year. Mercy has a staff of more than 2,100 people, according to its website.